Antibody therapies response

Treatment primarily consists of supportive care. Ventilate patient if they have difficulty breathing and administer oxygen. Be prepared to treat for shock. Monitor and support cardiac and respiratory functions as necessary. If the identity of the toxin is known, administer antidote if available. Unlike chemical agents, toxins can cause an immune response. Vaccines are available for some toxins but generally require more than 4 weeks for the body to produce antibodies. Passive immunotherapy is effective for some neurotoxins but must be instituted shortly after exposure. The utility of antibody therapy drops sharply at or shortly after the onset of the first signs of disease. 

There are two major factors predisposing to resistance to monoclonal antibody therapy. One is a tumor-related factor such as antigen loss, complement resistance antigen expression, intrinsic resistance, or tumor burden. Besides tumor-related factors, growing evidence has indicated that patient-related factors may account for the different responses of the patients to monoclonal antibody therapy. For example, differences in ADCC or CDC function according to individuals may increase our understanding of... 

Monoclonal antibody therapy (MAT) makes use of all the major features of the immune response. It involves vaccination/ immunization, albeit in experimental animals, to induce the desired specific immune response. It exploits the high specificity, selectivity, and affinity of the antibody CDR toward the target antigen to be recognized, highlighted, inactivated, or eliminated, using the characteristics of the Fc portion of an immunoglobulin to facilitate the means for such inactivation or elimination and for selection of appropriate effector mechanisms. Finally, MAT represents a modern form of serotherapy, in which parenteral administration of whole serum or Ig preparations has been replaced by recombinant antibody molecules of a defined specificity. 

Schroff RW, Foon KA, Beatty SM, Oldham RK, Morgan AC Jr. Human anti-murine immunoglobulin responses in patients receiving monoclonal antibody therapy. Cancer Res 1985 45(2) 879-85. 

Kigawa, J., Minagawa, Y., Kanamori, Y., et al. (1998) Glutathione concentration may be a useful predictor of antibody-cytotoxic agent conjugates for cancer therapy response to second-line chemotherapy in patients with ovarian cancer. Cancer, 82, 697-702. 

There were two obstacles that antibody therapies had to overcome to get into the clinic. First, a production method would be needed to produce and purify antibodies on a massive scale. This has largely been accomplished by creating hybridoma cell lines able to grow to high density, in serum-free conditions, and other necessities critical for commercial production. Second, non-human antibodies will illicit an inunune response regardless of the epitope. Therefore, antibodies needed to be produced by a rodent, but appear human to our inunune system. Molecular biology techniques were used to create chimeric and later fully humanized antibodies, the distinction is characterized by the ratio of mouse and human DNA. 

Jurcic JG, et al. Monoclonal antibody therapy of cancer. Cancer Chemother Biol Response Modifl997, 17, 195-216. 

Suttmann H, Riemensberger J, Bentien G, Schmaltz D, Stockle M, Jocham D, Bohle A, Brandau S (2006) Neutrophil granulocytes are required for effective bacillus Calmette-Guerin immunotherapy of bladder cancer and orchestrate local immune responses. Cancer Res 66 8250-8257 Tindle RW (1996) Human papillomavirus vaccines for cervical cancer. Curr Opin Immunol 8 643-650 Tobinai K (2007) 4. Antibody therapy for malignant lymphoma. Intern Med 46 99-100... 

Specks U, Fervenza FC, McDonald TJ, et al. Response of Wegener s granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthritis Rheum 2001 44(12) 2836-2840. 

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